Viability Imaging

While medical advances continue to improve the survival of those with a diagnosis of HF, it unfortunately remains a disease with an extremely poor prognosis. Thus, given the impact that ischemic HF places on patients and the health-care system, management strategies aimed at improving outcomes have been a prominent focus of research for many years. Specifically, the role that revascularization can play to improve patient outcomes has been widely investigated. In this regard, research on the utility of viability imaging to indicate which patients may benefit most from revascularization has demonstrated great potential in some studies, but not in others. As such, data is not uniformly consistent toward definitive conclusions on the role of viability detection. This chapter will discuss the concept of myocardial viability, the multimodality imaging tools available to assess viable myocardium, the new advances through research in this field, the clinical applications of viability assessment, and future directions in the area.